Tuesday, May 29, 2007

The other week's Sunday Post carried an interesting story from writer Liza Mundy, who wrote the "Everything Conceivable" book referenced in my last post. I can't help but think the Post published it intending it to be yet another one of those articles meant to portray abortion sympathetically (in this case, the practice of "selective reduction" of individual fetuses from multiples pregnancies caused by ART), as it followed an abortion doctor throughout a few of his typical days -- but instead, it became yet another article that portrayed the practice so honestly that its evil could not help but be exposed. In that sense, then, I think Mundy was doing her job well. According to Stanley Kurtz, Mundy "largely favors the brave new world she portrays," but nevertheless is honest enough not sugarcoat its realities. Rather, the brutal reality of the world of selective reduction is quite evident in the article.

Among the many risks of ART is a higher risk of birth defects or low birth weight and related problems, even among singletons, but particularly among the many higher-order multiples that tend to be conceived in these procedures. Some people, though undoubtedly scared, put faith in God and accept the children they have conceived, knowing their lives will be forever changed but accepting the responsibilities, joys and sorrows all together. But many couples opt for abortion of some of the multiples. They justify this by saying it will make for a safer pregnancy for them (likely true) and better odds for the remaining children (also possible, though not at all certain) - or they justify it simply by saying they could not afford/handle raising multiples. In this case, none was quite so divorced from human feeling as to undertake reduction just so they wouldn't have to start shopping at Costco (N.B., in that case the triplets pregnancy was natural) - but the logic of reduction is still cruel and chilling. First, the abortion doctor (Mark Evans, here) goes on what George Will, the father of a boy with Downs Syndrome, correctly terms a "search and destroy" mission for any babies who are slower to develop or who appear to have abnormalities indicating Downs or other conditions. If all of them look equally healthy, the doctor might make the call based on gender. Two boys, one girl? One of the boys will probably have to go. Ethicists all seem to agree that's an ethically sound form of sex selection, as opposed to sex selection done for the "wrong" reasons. Finally, if there's no other way to pick which baby to eliminate, it may come down to just an accident of placement in the womb -- closest to the needle, first to go. There's absolutely no mistake about what's going on here, since the first steps in the procedure involve detailed ultrasounds, and few of the patients have any illusions. Indeed (and again, going to how great this "choice" is), some are terrified, some are pressured, and some are horribly guilt-ridden (though not enough to stop the procedure).

[O]n Greenbaum's screen were three little honeycombed chambers with three fetuses growing in them. The fetuses were moving and waving their limbs; even at this point, approaching 12 weeks of gestation, they were clearly human, at that big-headed-could-be-an-alien-but-definitely-not-a-kitten stage of development. Evans has found this to be the best window of time in which to perform a reduction . . .

So far, there was nothing anomalous about any of the fetuses. Greenbaum turned the screen toward the patient. "That's the little heartbeat," she said, pointing to the area where a tiny organ was clearly pulsing. "And there are the little hands. There's the head. The body."

"Oh, my God, I can really see it!" the patient cried. "Oh, my God! I can see the fingers!"

"Okay!" she said, abruptly, gesturing for the screen to be turned away. She began sobbing. There were no tissues in the room, so her husband gave her a paper towel, which she crumpled to her face. The patient spent the rest of the procedure with her hospital gown over her face, so she would not see any more of what was happening.

WHAT WAS HAPPENING WAS DAY ONE OF A TWO-DAY PROCESS, in which one of the woman's three fetuses would be eliminated through an injection of potassium chloride, which stops the fetal heart.

Greenbaum, the nurse, twists herself ethically to say she'd never work at an abortion clinic, but somehow this is fine. Yet: "It's a very hard procedure, because the baby is moving, and you are chasing it. That is what is very emotional -- when the baby is moving and you are chasing it." Hunting it down.

Mundy, to her credit, points out the contradictions inherent in ART patients praying for children and then deciding "God gave me too many." It is a form of playing God. I doubt articles like this will really make a dent in the number of people who nevertheless keep spending and trying for ART pregnancies and subsequently face multiples pregnancies, but again, anything that shines light on this darkness is ultimately serving the good.

Tuesday, May 22, 2007

I've been writing about and trying to follow IVF and assisted reproductive technologies for years, but even when you highlight the occasional feature articles and profiles on the subject, you still get the feeling that people aren't seeing the broader picture. Anything that helps spread information on the subject to a wider audience, then, is a good thing -- like Slate's article a few weeks ago about two new books on infertility treatments.

(Of course, there is a major problem when articles like this only start coming out many years after a multi-billion dollar industry is entrenched and it can seem too late to *do* anything about it, but you have to take these stories where they come, I suppose . . . ) One key question, for instance, that you don't often see raised is this:

[Mundy's] book offers an important chronicle not only of the existing technology, but also of the unanswered questions about the short- and long-term implications of reproductive medicine. Why, for example, do IVF babies—not just twins, but singletons, as well—tend to be born prematurely and smaller compared to non-IVF children? Why, too, are there higher rates of birth defects, including bowel and genital deformations, as well as a form of eye cancer, among IVF children? Mundy notes that parents who have trouble conceiving may somehow differ genetically from their fertile counterparts. Or the problems may be related to some aspect of fertility treatment. We don't have the answers yet, but patients should at least know about the question marks.

The books also talk about how the emotional desperation involved for so many families using ART leads them to ignore risks like this and be vulnerable to the commercial industry that often charges them more than $10,000 per cycle (and the odds of success in the first cycle are shockingly lower than you might think given the hype - less than 30%, the last time I read). I tend think the best solution would be to move away from using these technologies at all - not merely getting government involved to regulate - but in the meantime just getting people to think more carefully about all of the issues involved is important.

Monday, May 21, 2007

I've actually been motivated to blog lately . . . just as work has picked up significantly. All the deals have to close by the end of the month, and even though they probably won't, we have to act like they will. It's good experience - I'm helping on the sale of several portfolios of retail properties - and I'm enjoying it, but often working from home every night, so no blogging. I did get to make the trip this past weekend to South Bend, though, for my younger brother's graduation from Notre Dame. It was great to see my family and be back on campus. The commencement itself was a very nice ceremony. They need to move it out of the JACC, since it simply does not work to force elderly relatives to climb up bleachers without railings, and it isn't especially fair to not have enough seats for all relatives of the graduates to actually see the ceremony. Nevertheless, it was a great thing to see, and the speakers all did a nice job too. The valedictorian, Michael Rossmann, who I think is the younger brother of one of my classmates (who was a pretty successful guy himself), was amazingly accomplished and is planning to become a Jesuit priest (at the same seminary where another one of my world-traveler classmate friends is currently studying). The commencement speaker, the CEO of GE, had a nice speech as well, and earned some appreciative applause when he joked several times about being the main guy in charge of televising our football games every fall. [Note to NBC: Production values can still be improved on the telecast, and maybe it's about time for some new announcers . . . but hey, it's nice to have the contract at all, right? :) ]

I never feel nostalgia so acutely as when I am remembering Notre Dame. Reading ND Magazine updates on all the classes throughout the years and seeing the different stages of life we all pass through produces an almost physical pang. The recent graduates are all getting married and having children; as you move back twenty-five years alums are reaching the top in their businesses and sending their kids to college; as you move back twenty-five years the alums are moving into retirement and sending news about their grandkids and their battles with cancer; and as you move back twenty-five years from that, you catch a few glimpses into the lives of a disappearing generation that still loves the same place you do.

Walking around campus evokes a similar feeling. I've only been out of school there five years; it's hardly as though my friends have passed on or anything - in fact, I was thrilled to see and talk to many of them just a few months ago at my wedding, and my best friend's own wedding is coming up soon. Still, as there are unfamiliar, newly raised buildings and other changes around campus, it all feels different and yet the same. Walking around the corner to the front of South Dining Hall, I felt as though I would surely see my regular group of friends waiting on the steps there. If I had walked into Stanford, I would hear the Irish songs playing at a party my friends were throwing. If I'd turned down the steps at SDH, I would find the old Scholastic team putting together the next issue. If I'd walked down the hallway in Lyons, I would find my friend leaving a message on the white board. I did actually see Fr. Poorman, who warmly said he missed seeing me at Keough Mass every Sunday night, as I used to attend with my friend from Texas whom I now haven't seen in a few years. These memories - these ghosts - are everywhere you step at this place. They mean more to me than I can even express sometimes except through a simple, profound sense of gratitude. But while the new students pass through each year and new buildings are constructed, I look to the connection to the past with the present - to newer memories of my own, like sharing hot wings and beer (well, I had Dr Pepper :) with my ND friends after my wedding and reception where they gave me an amazing scrapbook full of photos and reflections from our undergrad days (I have an inordinate number of friends who went to graduate and professional schools!), and the cross-country phone calls to share our news with each other as we all start to move forward through our own new stages of life, and backwards in the alumni class listings. It's hard to say much more except - this place is truly blessed.

Sunday, May 06, 2007

Well, I'm not napping -- I'm reviewing title commitments and surveys for the afternoon, fun fun -- but I had to post these cute otters for your (well, at least my mother's!) viewing enjoyment. Here ya go:

Part of practicing in commercial real estate involves reading old property documents, and occasionally I run into tidbits that are rather shocking to modern sensibilities. I've seen a lot of conveyances and title deeds to "John Q. Smith and wife" -- as if said wife was so much of an afterthought that it wasn't even worth recording her name. (I can promise when I buy a house with my husband, my name will definitely be on the deed, thank you very much.) A lot of times I'll also see title companies noting "covenants, conditions, and restrictions agreements" pertaining to the land but specifically excepting anything in those agreements that violates the Civil Rights Act. Sometimes I wonder why they have to be so careful to exclude such provisions -- but then today I read an actual deed from the 1920s in which the purchaser promised that the land would never be owned or occupied except by members of the White race. Wow. I remember Shelley v. Kraemer, but don't usually come across for myself examples of what that case was dealing with. Sometimes it's good to be reminded and grateful of how far we've come since the days that such blatant prejudice and offensiveness was actually sanctioned by the law.

Wednesday, May 02, 2007

I was going to go grocery shopping after Brady Quinn got picked on Saturday, so I figured I'd be able to head about by 1 or so. Turned out I wasn't able to leave until closer to 5, since, as everyone knows by now, the selection process did not go exactly as planned. I wasn't too concerned when Brady wasn't picked in the first several selections, as I was convinced that the Dolphins would grab him at #9. Their most likely current starter was "Cleo Lemon," which sounds more like a stage name for a 1940s jazz singer than an NFL starting quarterback. Quinn to Miami would have been a fantastic match. And it all looked meant to be, until the Dolphins' new coach announced he wanted an average-to-good receiver/punt returner who just happened to be an old family friend: Ted Ginn Jr. You can watch the reaction here:

And watch again. And re-watch. Oh, it's so painful. Ouch. What a colossally dumb move by the Dolphins. One fan on the team boards was so upset he misspelled his exclamation as "WFT???" Heh. Anyway, I felt their pain. It was not a great move, since who was supposed to be throwing to this great new receiver? Even though Miami did later pick the 26-year-old BYU QB John Beck, they could have had a guy who's already had two years under a pro coach, with great accuracy and decision-making.

I think you had to feel Brady Quinn's pain, too, or at least the awkwardness of having the cameras focused on him during every selection announcement. I'm glad the commissioner eventually pulled him away from the cameras, since even though it was only to be expected that teams with mid-round selections wouldn't pick quarterbacks since they all had them, it still would have been hard to watch the next couple of hours if Brady was still out in public, waiting. I'm not thrilled he has ended up going to the Browns after all of that, but he really does love that team, they seem happy to have him in turn, and I hope it ends up being a good fit. At least he will have a good offensive lineman in front of him.

Other Irish players drafted included Abiamiri (by the Eagles) and Ryan Harris (by the Broncos). Darius Walker signed as a free agent with the Bears, and I hope he earns a spot on the team. Overall, it was the best draft for the team since 1997. As for my other pro interests, it looks like the 49ers had a solid draft, as they picked up a few defensive linemen, including LB Patrick Willis from Mississippi in the first round. I hope to see these players contribute to the slowly ongoing improvement in San Francisco next year.